All About Food Allergies

Are you unsure if your child has a food allergy or what you should do if your child has an allergic reaction? MH checks with the experts on everything you need to know about food allergies.

WORDS NURULHUDA SUHAIMI

Does your child always experience adverse reactions such as rashes or breathing difficulties when he eats a particular food? If he does, your child might have a food allergy.

According to associate consultant, Dr Alison Joanne Lee, Division of Paediatric Allergy, Immunology & Rheumatology, NUH, the most common food allergies among Singapore toddlers are egg allergy (about 1.5 per cent) and cow’s milk allergy (less than 1 per cent).

If you suspect your child has a food allergy, ensure you check with a doctor first. “Confirm the diagnosis with an allergist, who will perform skin and/or blood tests. We see many children with suspected food allergies and often this is not true,” says Dr Lee. This happens at times because some parents may mistake their child’s reaction to a particular food as an allergy when it is not necessarily the case.

Is it Really a Food Allergy?

First of all, we have to highlight the differences between food allergy and food intolerance. Dr Lee clears this misconception.

“A food allergy is when the body’s immune system sees that food as foreign and overreacts to it when it is eaten. It can affect multiple organs in the body, including the skin, intestines, respiratory and cardiovascular systems. These allergic reactions may get worse if you give the food again because the immune response gets stronger and can be life-threatening,” she explains, “Food intolerances are more like “side effects”. They are usually less serious and don’t get worse or become life-threatening with subsequent ingestions. For example, monosodium glutamate (MSG) causing headaches or spicy food causing diarrhoea.”

How do I Know if it’s a Food Allergy?

Paying attention to the kind of reaction your child has after consuming a certain food is important to determine whether he has a food allergy or food intolerance. Examples of reactions that occur due to food intolerance are bloating, nausea, diarrhoea and migraine.

The symptoms of a food allergy, however, vary from mild to severe. “Mild symptoms include rash, hives, itching of the skin, swelling around the eyes and abdominal discomfort. Severe symptoms include breathing difficulties, tongue and throat swelling, wheezing and loss of consciousness,” says Dr Sii Sik Liong, resident doctor at Dr Tan & Partners @ Scotts.

It is important to note that your child may experience different symptoms consecutively if he has an allergic reaction to something he has eaten. Reactions typically start with skin symptoms. The extent of the allergic reaction may also differ on different occasions; if your child has a mild reaction on one occasion, he could still experience a more severe reaction the next time he eats the food allergen.

How Much of a Food Allergen has to be Consumed to Cause a Reaction?

The amount it takes for a food allergen to lead to an allergic reaction depends on the type of reaction and previous exposure, according to Dr Goh E Shaun, specialist in Emergency Medicine & Consultant, Raffles Hospital. “If the child is particularly very sensitive to the food allergen, then even a minute amount is sufficient to trigger a reaction,” says Dr Goh.

How Long does it Take for Symptoms to Appear?

Symptoms may occur within minutes to two hours after consuming the food allergen. There are also cases where the second wave of symptoms appears one to four hours after the first symptoms have been treated. This is known as a biphasic reaction. The second wave of symptoms is the same as the symptoms of the first reaction, but their severity may differ.

Due to the risk of a biphasic reaction occurring, it is important for your child to be monitored in the hospital for at least 24 hours, particularly if he had a severe allergic reaction the first time.

Can Symptoms be Fatal?

Food allergy symptoms can be life-threatening if they are not treated immediately, especially for severe symptoms. “Symptoms such as wheezing, breathing difficulties and tongue swelling can become fatal if not treated immediately,” warns Dr Sii, “[The child’s] airway may be completely obstructed and [his/her] blood pressure may drop significantly. This is known as anaphylaxis and it is life-threatening.” In extreme cases, anaphylaxis may even lead to a loss of consciousness.

When Should I seek Medical Help?

Of course, if your child is having a severe allergic reaction, you should seek medical help immediately because it can be fatal if treatment is delayed. “More severe symptoms such as wheezing, breathing difficulties, tongue swelling, dizziness and fainting should be treated as medical emergencies. Parents should bring [their child] to the emergency department immediately, or call for an ambulance,” says Dr Sii.

Even if your child is showing mild symptoms, you should still get him medical help straightaway. “Mild symptoms such as rash, hives, itching of the skin, swelling around the eyes, abdominal discomfort and nausea can be treated at GP clinics. Parents should inform the GP clinics about their children’s condition so they can be seen as a priority,” advises Dr Sii.

Just remember: to be on the safe side, seek medical help if your

child shows any symptoms of an allergic reaction.

Can My Child’s Food Allergy be Cured?

Unfortunately, there are currently no cures for food allergies. Prevention of an allergic reaction is key when it comes to food allergies, which is why strict avoidance of the food allergen in your child’s diet is important.

If your child has an anaphylactic reaction, then the only way to treat it immediately is by injecting him with epinephrine (adrenaline). This injection usually comes in the form of an adrenaline pen, such as the EpiPen. But be sure to call the emergency department after you have administered the epinephrine injection so a doctor can monitor his condition.

If your child’s doctor prescribed an adrenaline pen for your child’s allergy, ensure you always have it with you so you are prepared for any emergencies.

Will My Child have his Food Allergy for Life?

The permanence of food allergies depends on the specific food allergen. For example, egg and cow’s milk allergies will not continue to adulthood as most children will outgrow them. However, other food allergies such as peanut and shellfish tend to be lifelong. If your child has a food allergy, it is important for him to go for repeated allergy testing with a doctor to confirm if he has outgrown his allergy.

As we mentioned before, your child has to avoid the food he is allergic to entirely in his diet because even small amounts can trigger a reaction.

If you are cooking at home, be careful not to add the food allergen in your child’s share of the meals.

Check ingredients of packaged food and learn to read food labels. For instance, look out for statements on packaged food like “Contains peanuts” or “Contains egg”.

Checking for labels of cross-contamination warnings is extremely

important too. Some packaged food may have statements

like “Manufactured in a facility that also processes peanuts”.

This means even if the particular packaged food does not contain nut ingredients, it may still contain traces of peanuts.

Eating out also involves careful monitoring. Dr Lee recommends avoiding eating in places where ingredients can be mixed up or unknown such as buffets. If you are eating in a restaurant, check the menu carefully. To be more vigilant, Dr Goh advises parents to inform and remind the restaurant staff of your child’s food allergy.

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